The number of cancer patients with diverse needs requiring follow-up after treatment is growing. Sharing care with general practitioners is as effective as specialist care. The challenge was coordinating care between specialists and GPs. We piloted an e-care plan to schedule tasks and share information for colorectal cancer shared follow-up.
The shared e-care plan is an innovation that supports coordinated care. Tasks and responsibilities were tailored to meet patient needs. Information was shared (e.g. pathology results, progress notes) and the e-care plan monitored by the cancer service.
GPs found the e-care plan a useful tool and it gave them more confidence in providing care. It assisted some patients to be more involved. It was difficult putting the e-care plan into routine practice at cancer services.
Further work to scale shared e-care planning requires strategies that support transitioning to new routines and integrating the e-care plan with cancer service clinical information systems.
This study was funded by a Cancer Institute NSW Innovations Grant 2019